Liver abscess had been described as fatal disease before the turn of the century. There are two kinds of liver abscess, the etiology, clinical course, diagnosis, and management are different between pyogenic and amebic abscess. With the advent of
antibiotics and the development of newer imaging techniques, marked changes in diagnosis, treatment and prognosis have been reported.
In this study, a detailed review was performed in 74 patients treated for pyogenic or amebic liver abscess at the Gyeongsang National University Hospital from January, 1987 through June, 1993. Among 74 cases of liver abscess, 66(89.2%) were
pyogenic and
8(10.8%) amebic. The male to female ratio of liver abscess, 66(89.2%) were pyogenic and 8(10.8%) amebic. The male to female ratio of liver abscess was 1.1 : 1 in pyogenic, 7 : 1 in amebic, the peak incidence was in the 6th decade in pyogenic and
5th,
6th decade in amebic abscess. The most common portal of entry in pyogenic abscess was biliary tract(71.2%). Liver scan, abdominal ultrasound and CT scan was performed in 18.9%, 100%, 77% each with the each positive rate was 100%, 81.1%, and
98.2%.
The
most common organism of the pyogenic abscess was E. coli(46.3%). Secondary infection of amebic abscess was occurred in 1 case(12.5%). In the amebic abscess, antibody to ameba was positive in 6 cases(75%) and pus revealed chocolate brown or
anchovy
paste
like color in 7 cases(87.5%). In the pyogenic abscess, surgical drainage, percutaneous drainage or antibiotics alone was tried in 50.2%, 25.8%, 21.2% each and the each cure rate was 89.5%, 88.6% and 28.6%. The patients with amebic abscess were
cured by
amebicides alone(62.5%) or percutaneous aspiration(37.5$). The mortality rate of liver abscess was 12.1% in pyogenic and 0% in amebic. The factors influencing mortality in the pyogenic abscess were nonbliary origin, underlying malignancy,
multiplicity
of abscess, large abscess cavity(>10cm), involvement of both lobe and hypoalbuminemia(≤3g/dl). (Korean J Gastroenterol 1994 ; 26 : 506-520)
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